MAHADEVAN G KRISHNAN MD PC NPI 1407929185

NPI Information

NPI: 1407929185
Provider Name: MAHADEVAN G KRISHNAN, MD PC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
609 RIVER AVE
LAKEWOOD, NJ
ZIP 08701
Phone: (732) 901-8822
Get Directions

MAHADEVAN G KRISHNAN, MD PC is a vascular surgery surgery in Lakewood, NJ. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. MAHADEVAN G KRISHNAN, MD PC NPI is 1407929185. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

609 RIVER AVE
LAKEWOOD, NJ
ZIP 08701-227
Phone: (732) 901-8822
Fax: (732) 367-2897

The provider's authorized official is Mahadevan G Krishnan .
The authorized official title is President and has the following contact phone number (732) 901-8822.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 11/28/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0129X	Surgery	Vascular Surgery	25MA045854	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080616	MEDICARE PIN	NEW JERSEY
2	C60258	MEDICARE UPIN	NEW JERSEY
3	542526	MEDICARE ID-TYPE UNSPECIFIED	NEW JERSEY
4	DB3539	OTHER	NEW JERSEY	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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